Individual
MS. SARETTE J KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
180 WINGO WAY, SUITE 207, MOUNT PLEASANT, SC 29464-1810
(843) 884-5101
(843) 849-7726
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2056
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1842PA
—
SC
Enumeration date
01/17/2014
Last updated
07/13/2021
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